| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | HARVARD PILGRIM HEALTH CARE | $17K | $8K | $26K | 1.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $4K | — | $4K | 0.27% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | HARVARD PILGRIM HEALTH CARE | $9K | $4K | $13K | 1.88% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MA | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $2K | — | $2K | 0.27% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.48% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE AGENCY OF V | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $331 | $331 | 1.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $858 | — | $858 | 6.44% |
| YOZELL INSURANCE, A DIVISION OF BRO3 | 155 FEDERAL STREET #1500 BOSTON, MA 02110 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $367 | — | $367 | 2.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $456 | — | $456 | 16.45% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE AGENCY OF V | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $7 | $7 | 0.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MA EIN 04-6143185 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $149K |
| BROWN & BROWN INSURANCE SERVICES, I BROKER | Insurance agents and brokers Service code 22 | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | $2K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HARVARD PILGRIM HEALTH CARE | 115 | $2.0M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 79 | $13K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 200 | $31K |
| Prescription drug(2 contracts) | HARVARD PILGRIM HEALTH CARE | 115 | $2.0M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.